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VOMITING
Gastro esophageal Reflex or just Reflex
Infants up to age 6-8 months often have an immature valve between the stomach and esophagus. Anytime the stomach contracts, these babies get a small amount of milk pushed into the esophagus instead of the intestine. The result is a gush of milk all over Mom’s new dress or Dad’s favorite coat. This is very common, but is not serious unless the baby is unable to gain weight and thrive. Treatment consists of:
Gastroenteritis
This disease may be accompanied by fever and diarrhea. Treat by:
Summertime is the usual time for the "stomach virus" to attack your children. There is nothing more unpleasant for families, nor more frustrating for doctors to treat than a baby with "runny bowels". Fortunately, in this country, that’s all this malady is---unpleasant! However, worldwide, this disease and the accompanying dehydration is one of the causes for high infant mortality, particularly in developing countries. Sanitary water and sewage systems together with readily available medical management have drastically reduced diarrhea in developed countries to a nuisance level.
But even modern times have seen a particular type of diarrhea due to the employment of both parents. Their children have to be left in day-care, where the child has an increased risk from diarrhea diseases. Diarrhea in day care centers frequently involves children who are not toilet trained. Even in the best of centers, it is very difficult for the staff members to wash their hands between handling of infants and changing diapers, resulting in the transmission of infectious agents, usually viruses, to other children. In addition, the staff rarely disinfects the changing areas. Parents can minimize their child’s risks by carefully choosing day cares, where the staff has been trained in control of infection spread. There is a clear association between diarrhea in the classroom environment and the presence of fecal bacteria on the children’s hands, suggesting that the outbreaks and transmission may be prevented, if proper cleaning and disinfecting principles are followed.
While the child is ill you will need to check frequently for signs of dehydration: (1) dry mouth, (2) no tearing when crying, (3) dry skin that stays wrinkled when pinched, and (4) decreased urine (less than 2-3 times in 24 hours). It is especially important to pay attention to urine output, as this is your best indication of the seriousness of the disease. The frequency, color, and consistency of stool are also important to be aware of but there is usually no way to ignore this! Recent diet changes and temperature changes are also important.
Medications in children over 2 years of age can be effective such as Pepto-Bismol, Imodium and Kaopectate. But the most effective treatment consists of decreasing feedings. A good rule of thumb is "nothing in, nothing out." But only in moderate to severe diarrhea (6 to 10 stools per day) is it necessary to limit the diet at all. When needed, first stop all milk and solid food for 24 hours. Give only Gatorade, fruit juices, or an electrolyte solution such as Infalyte or Pedialyte. After 24 hours begin crackers, toast, bananas, and cereal. On the third day begin a normal diet.
Call your child’s doctor if the following occur:
A good definition of constipation is large, hard bowel movements that are difficult to pass without tearing the rectum. Humans vary a great deal in their need to have a bowel movement. This certainly applies to babies. It seems that what is natural is what is natural for your child. Every child will establish his/her own bowel pattern. Don’t think your baby is constipated because he doesn’t go as you expect. He may be normal if he’s not uncomfortable. Usually it is better to wait than treat constipation.
A baby who cries, groans, strains and gets a red face, then passes a formed stool
A child who has a firm stool every 2-3, or even 4 days
A breast baby who does not have frequent stools
Treat only if Constipation exists
Increase fluid intake
For infants, add dark corn syrup, 1 tsp. to each bottle
Avoid enemas and laxatives until you talk with your doctor
Parasites
Serious intestinal parasites in the US have become very uncommon. Worms usually come from contaminated water supplies. Worm eggs must be eaten to grow in a child’s intestine. Pinworms, however, are very common and may be found in every child at one time or another. Fortunately, these parasites are not serious. Usually, they cause no symptoms at all. Some children can experience severe rectal itch. Pinworms do not cause stomachaches or poor eating habits. They can be easily treated, especially if your child has an itchy bottom. You can best detect these worms by spreading the cheeks of your child’s buttocks at night and examining with a good light. If present, they look like short white threads that wiggle. Rarely, your child may pass a round worm called Ascariasis. These really resemble common fish bait worms. They can be much more serious, so you will need to consult your doctor.Almost every parent asks their pediatrician a question (don’t call it a problem, because it is really not) about the their child’s erratic eating patterns at least once during their child’s life. The reason that it is not a problem is because it is a part of the normal developmental stage that most small children go through. They like to express their ability to make their own decisions and state their own preferences; it has really nothing to do with the food itself! Several suggestions were made:
Involve them in cooking the meal when they show an interest (usually around 4 years old).
Try to avoid discussing problems in the dining room (even though it’s a normal tendency for everyone to "unload" the day’s problems at supper time.)
Avoid meals (e.g., casseroles) that the child can’t identify the food ("camouflaged foods").
However, please realize that the strategy is not to get too "uptight" about these NORMAL swings of appetite that your kids have. Depending on their age and their growth requirements, some children may be "streak eaters" ---and only eat one or two foods for 2-3 weeks, only to switch to another previously rejected food later. Other children are "tank eaters"---they eat enormous quantities one week and eat like a bird the next week. Some children are "nibblers"---never eating much at meals but actually consume a lot in the course of a day. These are all NORMAL variations of a child’s behavior and should be no cause for alarm, as long as your child’s doctor assures you that growth and weight gain are following normal patterns.
If teething is not a disease, it needs no treatment. If you want to do anything at all, give the baby something to chew on. Teething powders and gels are not effective and accomplish no real purpose. Using them when a child has fever may lull you into thinking the child is treated, until the eardrum bursts to let you know that the real problem is an ear infection.
Dental Care
Developing teeth require fluoride from birth. This is usually present in water supplies. Those children who drink no "city water" need fluoride drops. Cleansing of the primary teeth is essential to avoid cavities. Early loss of the primary teeth can lead to decayed crooked permanent teeth. Brush and floss your child’s teeth beginning with the first tooth. Wean from the bottle by age 12 months and avoid continuous sugary feedings, including milk. After the age of 2 years, your child should visit the dentist yearly.